Ampicillin 50 mg/kg/day (100 mg/kg/day in meningitis) divided 12 hours IV and gentamicin 5 mg/kg/day divided 12 hours IV. Begin empiric therapy after cultures are obtained or before cultures if any delay is anticipated. There should be NO DELAY in antibiotic therapy. Should be tailored to age of onset, clinical setting, and initial findings. Hypocalcemia, hypoglycemia, hyponatremia, and DIC. Negative latex agglutination tests do not rule out infection, but positive results may help guide therapy. influenzae, group B streptococci, and meningococcus in blood, urine, and CSF is done even though the usefulness is questionable.

Latex agglutination test for pneumococcus, E. Cultures of blood, urine, and any other site as indicated. UA, CBC (remember neutropenia or thrombocytopenia are also suggestive of infection) and repeat in 5 hours, CXR and C-reactive protein.

Include LP for cell count, protein, glucose, and culture. Bulging fontanel is a very late sign of neonatal meningitis, and Brudzinski's sign or Kernig's sign is rarely found. May progress to respiratory distress, poor perfusion, abdominal distension, jaundice, bleeding, petechiae, or seizures. The presentation may include irritability, vomiting, poor feeding, poor temperature control, lethargy, apneic spells. Fever may be absent so watch for symptoms below. Presentation may be subtle thus any febrile neonate must have a septic work-up. coli, Klebsiella, Pseudomonas, Serratia, Staph. Also Listeria (rare in United States), Klebsiella, Enterococcus, Staphylococcus aureus (uncommon), Streptococcus pneumoniae, group A streptococci. Group B streptococci and Escherichia coli 60% to 70% of infections. Infants 24 hours), premature labor, maternal fever, UTI, foul lochia, chorioamnionitis, IV catheters (in infant), intrapartum asphyxia, and intrauterine monitoring (pressure catheter or scalp electrode). Significant morbidity, especially neurologic sequelae of meningitis. Neonatal bacterial sepsis is associated with 10% to 40% mortality and 2 Neonatal Bacterial Sepsis General comments. Mycostatin cream to maternal areola and nipple if breast-fed infant. Nystatin suspension 100,000 to 200,000 U PO QID for 7 days. White plaques on erythematous base over oral mucosa, tongue. Thrush Oral candidiasis peaks at 14 days of life. Ref: Cunningham FG, MacDonald PC, Gant NF, et al: Williams Obstetrics, ed 20. Treatment should focus on rapid control of symptoms and delivery of the infant. These symptoms indicate that the process is well advanced and that convulsions are imminent. The symptoms of epigastric pain and headache categorize her preeclampsia as severe. admitting the patient to the hospital, treating with parenteral magnesium sulfate, and planning immediate delivery either vaginally or by cesarean sectionД This patient manifests a rapid onset of preeclampsia at term. admitting the patient to the hospital for bed rest and monitoring, and beginning hydralazine (Apresoline) to maintain blood pressure below 140/90 mm Hg d. admitting the patient to the hospital for bed rest and frequent monitoring of blood pressure, 1

strict bed rest at home and reexamination within 48 hours b. The most appropriate treatment at this point would be a. A urinalysis shows 2+ protein she has gained 5 pounds in the last week, and has 2+ pitting edema of her legs. She has had an uneventful pregnancy to date and had a normal prenatal examination 2 weeks ago. She complains of severe headaches and epigastric pain. You see a 23-year-old gravida 1 para 0 for her prenatal checkup at 38 weeks gestation. Physician Task 8%-12% Obtaining history and performing physical examination 8%-12% Using laboratory and diagnostic studies 8%-12% Formulating most likely diagnosis 8%-12% Evaluating severity of patient's problems 8%-12% Applying scientific concepts and mechanisms of disease 45%-55% Managing the patient health maintenance clinical intervention clinical therapeutics legal and ethical issues

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